Study of efficacy and safety of MIJ821 in addition to comprehensive standard of care on the rapid reduction of symptoms of Major Depressive Disorder (MDD) in subjects who have suicidal ideation with intent
The main purpose of this study is to support the dose selection for future Phase III clinical trials by evaluating efficacy and safety of four MIJ821 doses (very low, low, high and very high) administered every other week by intravenous infusion on top of pharmacological antidepressant treatment, compared with placebo, for the rapid reduction of the symptoms of MDD in participants who have suicidal ideation with intent. In addition, the study will explore the effect of single dose administration of very high and high doses to treat MDD in participants who have suicidal ideation with intent. The study consists of three periods: a Screening Period (up to 48 hrs), a double-blind Core Period (6 weeks) and Extension Period (up to 52 weeks). The Extension Period will explore durability of the effect of the study treatment and the effect of MIJ821 on relapse rate, as well as safety of repeated MIJ821 administration. All patients in the extension period will receive active treatment.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
200
MIJ821 supplied in vials to be prepared on a mg/kg basis and to be administered for 40 minutes IV infusion on Day 1, Day 15 and Day 29
40 minutes IV infusion of 0.9% sodium chloride solution on Day1, Day 15 and Day 29
Change from baseline in the total score of the Montgomery Åsberg Depression Rating Scale (MADRS)
The Montgomery Åsberg Depression Rating Scale (MADRS, SIGMA version), is a clinician rated scale designed to measure depression severity and detects changes due to antidepressant treatment. The test consists of 10 items, each of which is scored from 0 (item not present or normal) to 6 (severe or continuous presence of the symptoms), for a total possible score of 60. Higher scores represent a more severe condition. The MADRS evaluates apparent sadness, reported sadness, inner tension, sleep, appetite, concentration, lassitude, interest level, pessimistic thoughts and suicidal thoughts. The MADRS will be collected electronically by qualified personnel
Time frame: Baseline (first infusion) at 24 hours and up to 52 weeks
Number and severity of treatment-emergent adverse events (TEAEs) and adverse events of special interest (AESI)
Treatment-emergent adverse events (TEAEs) and adverse events of special interest (AESIs) will be collected at all study visits
Time frame: Baseline up to 6 weeks
Pharmacokinetics (PK) of MIJ821 in plasma
PK parameters of MIJ821 in plasma after 1st infusion described by AUClast, Cmax, Tmax and after each other infusion described by Cmax and Tmax. In order to better define the PK profile, the timing of the PK sample collection may be altered based on emergent data.
Time frame: Baseline up to 52 weeks
Percentage of participants meeting response criteria of ≥50% reduction
Response criteria of ≥50% reduction from baseline in MADRS total score over time in the Core Period.
Time frame: Baseline up to 6 weeks
Percentage of participants meeting criteria for sustained response of ≥50% reduction
Sustained response from baseline in MADRS total score for a period of at least four weeks in the Core Period
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Novartis Investigative Site
Birmingham, Alabama, United States
Novartis Investigative Site
Farmington, Connecticut, United States
Novartis Investigative Site
Oakland Park, Florida, United States
Novartis Investigative Site
Atlanta, Georgia, United States
Novartis Investigative Site
Rockville, Maryland, United States
Novartis Investigative Site
DeSoto, Texas, United States
Novartis Investigative Site
Buenos Aires, Argentina
Novartis Investigative Site
Fortaleza, Ceará, Brazil
Novartis Investigative Site
São Bernardo do Campo, São Paulo, Brazil
Novartis Investigative Site
Toronto, Ontario, Canada
...and 29 more locations
Time frame: Baseline up to 6 weeks
Percentage of participants meeting remission criteria of MADRS total score of ≤12
Remission criteria of MADRS total score of ≤12 over time in the Core Period
Time frame: Baseline up to 6 weeks
Percentage of participants meeting sustained remission criteria of MADRS total score of ≤12
Remission criteria of MADRS total score of ≤12 sustained for a period of at least four weeks in the Core Period
Time frame: Baseline up to 6 weeks
Percentage of participants meeting criteria for relapse in the Extension Period
Relapse for all patients meeting criteria for relapse over fixed period in the Extension Period
Time frame: From 6 weeks up to 52 weeks
Percentage of relapsing participants meeting response criteria or remission criteria after the first infusion
Relapsing participants meeting response criteria or remission criteria after the first infusion of MIJ821 retreatment in the Extension Period
Time frame: From 6 weeks up to 52 weeks